Definitions HPM 101

Question 1

Health

Answer 1

A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.

Question 2

Health system

Answer 2

delivers quality services to all people when and where they need them. Consists of all organizations, people, and actions whose primary intent to promote, restore, and maintain health

Question 3

Health Care

Answer 3

refers to medical services, health system and health policy involves all areas including public health.

Question 4

Social epidemiology

Answer 4

studies the distribution of a disease within a population according to social factors, such as use of drugs or heterosexual behavior or social class, rather than biological factors such as high blood pressure.

Question 5

Prevalence

Answer 5

refers to the total number of cases within a specified population at a specified time-both those newly diagnosed and and those diagnosed in previous years but living with the condition under study.

Question 6

Incidence

Answer 6

refers to the number of new occurrences of an event (disease, birth deaths, etc.) within a specific population during a specified period.

Question 7

Life expectancy

Answer 7

the average period a person may live. Reflects the overall mortality level of a population. It summarizes the mortality pattern that prevails across all age groups-children and adolescents, adults, and the elderly.

Question 8

Maternal mortality

Answer 8

the annual number of female deaths from any cause related to or aggravated by pregnancy or its management during pregnancy and childbirth.

Question 9

Infant mortality

Answer 9

is the death of an infant before his or her first birthday. Is the number of infant deaths for every 1,000 live births.

Question 10

Morbidity

Answer 10

departure from a state of physical or psychological well-being, resulting from disease, injury, or sickness. Disability may be limited to a few days during acute illness with measles or years of disability with blindness.

Question 11

Mortality

Answer 11

the frequency or rate of death in each population.

Question 12

Upstream factors

Answer 12

Are closer to the fundamental cause and often farther from the observed health outcome. (Examples- income, accumulated wealth, educational attainment, and experiences based on racial or ethnic identification)

Question 13

Midstream

Answer 13

features of neighborhoods and work environments.

Question 14

Downstream

Answer 14

factors are closer to the causal chains such as unhealthy diets, lack of exercise, and smoking (proximate)

Question 15

Social class- Social economic status (SES):

Answer 15

Social class refers to individuals’ education, income, and occupational status or prestige. Where people are in a social hierarchy affects the conditions in which they grow, learn, live, work and age, their vulnerability to ill health and the consequences of ill inequalities.

Question 16

Building Blocks

Answer 16

Leadership/governance, health care financing, health workforce, medical products and technologies, information and research, service delivery to achieve goals such as improved health (level and equity), responsiveness, financial protection, improved efficiency.

Question 17

Epidemiological transformation

Answer 17

Antibiotics and vaccines along with improved nutrition, general health and social welfare led to dramatic reductions in infectious disease morbidity and mortality.

Question 18

Cultural competency

Answer 18

acknowledges and incorporates importance of culture, vigilance toward the dynamics that result from cultural differences, adaptations to meet culturally unique needs. A culturally competent system is built on awareness of the integration and interaction of health beliefs and behaviors, disease prevalence and incidence for different patient beliefs. (There are some problems with cultural competence)

Question 19

Cultural Humility

Answer 19

refers to an orientation towards caring for one’s patients that is based on: self-reflexivity and assessment, appreciation of patents’ expertise on the social and cultural context of their lives, openness to establishing power-balanced relationships with patients, and a lifelong dedication to learning. Meaning that one does not know and is willing to learn from patients about their experiences, while being aware of one’s own embeddedness in culture(s).

Question 20

Primary prevention

Answer 20

the goal is to protect healthy people from developing a disease or experiencing an injury in the first place.

Question 21

Secondary prevention

Answer 21

These interventions happen after an illness with serious risk factors has already been diagnosed. The goal is to halt or slow the progress of disease (if possible) in its earliest stages; in the case of injury, goals include limiting long-term disability and preventing re-injury. (Examples: low dose of aspirin to prevent heart attack, screenings, regular exams)

Question 22

Tertiary prevention:

Answer 22

Focuses on helping people manage complicated, long term health problems such as diabetes, heart disease, cancer and chronic musculoskeletal pain. The goals included preventing further physical deterioration and maximizing quality of life. (Example: cardiac or stroke rehab, management programs, patient support groups)

Question 23

Community rating

Answer 23

A health plan sets the same premium rate for everyone in each geographical area. The insurer thus ignores any differences in expected costs among insured groups or people (previous illness, existence of chronic conditions, risky lifestyles etc.) It achieves redistribution of health care more in accordance with human need from healthy to sick and from rich to poor.

Question 24

Experience rating

Answer 24

People pay different premiums based on differences in their demographics, past health care utilization, medical status and other factors. This type of ‘experience or actuarial rating’ is used to minimize risk associated with policyholders who have high-risk related conditions.

Question 25

Redlining

Answer 25

The refusal of coverage to certain individuals or groups on the basis of geographical location, belonging to certain business groups that were considered as high-risk or on the basis of history or excessive claims.

Question 26

Premium

Answer 26

Payments by the insured on a monthly or annual basis to cover the specific set of losses indicated in the insurance policy.

Question 27

Deductible

Answer 27

The amount you must cover for medical expenses before your insurance policy starts paying. Deductibles are usually made on an annual basis.

Question 28

Out-of-pocket maximum

Answer 28

A cap or limit on the amount of money you have to pay for covered health care services in a plan year.

Question 29

Co-payment

Answer 29

a contribution made by the insured person toward the cost of medical treatment or other services.

Question 30

Co-insurance

Answer 30

the percentage under an insurance plan that the insured person pays toward a covered expense or service.

Question 31

Universal health coverage

Answer 31

a system where everybody is covered.

Question 32

Equity

Answer 32

the idea that everyone should have a fair and just chance to achieve their best health, regardless of factors that can affect health outcomes.

Question 33

Gender

Answer 33

Socially created and learned distinctions that specify the ideal physical, behavioral mental and emotional traits characteristics of males and females.

Question 34

Racial disparity

Answer 34

the increased presence and severity of certain diseases, poorer health outcomes and greater difficulty in obtaining healthcare services for certain races and ethnicities.

Question 35

Social gradient

Answer 35

People who are less advantages in terms of socioeconomic position have worse health (and shorter lives) than those who are more advantaged.

Question 36

Asymmetry of information

Answer 36

need to rely on physicians for the treatment decisions. Healthcare providers KNOW more than the patients about health problems. They have education and experience, i.e. expertise- to make treatment decisions.

Question 37

Employment-based insurance:

Answer 37

individuals receive insurance through their full-time jobs, this is private insurance. This concept evolved rapidly in the three decades after World War II. Employment based insurance allowed health insurance to be tax exempt if sponsored by employers. The employers offered health insurance as a fringe benefit to attract good workers. Substantial efficiency advantages of group over individual insurance.